insulin--(b1)-des-phe- and Diabetes-Mellitus

During a cross-over-study in 12 ambulant patients the effects of Optisulin -Depot CR in comparison to Depot-Insulin Hoechst klar CR were examined. After a period with Depot-Insulin Hoechst klar CR patients got Optisulin -Depot CR in the same dose and with the same diet. A week later patients took Depot-Insulin Hoechst klar CR once again. The different blood-sugar-curves corresponded to each other, but Optisulin -Depot CR showed more initial effect. The use of Depot-Insulin Hoechst klar CR is an advantage, because, Optisulin -Depot CR is neutral and no depot-substances are contained. Therefore, less allergic reactions are expected.

Topics: Adult; Aged; Blood Glucose; Clinical Trials as Topic; Diabetes Mellitus; Female; Glycosuria; Humans; Insulin; Ketone Bodies; Male; Middle Aged; Patient Education as Topic

In a randomised clinical study 20 diabetics were given a des-phe-mixed-insulin. The quality of diabetes control was investigated. The average age of the patients was 53 years; the duration of the diabetes was 8.7 years in average. As criterion of diabetes control were accepted: a daily urinary excretion up to 10 g and a peak value of blood-sugar in the daily profile of 9.99 mmol/l (180 mg/dl). In 9 of the 20 patients the diabetes could be controlled easily by using des-phe-mixed-insulin. In the remaining 11 patients no sufficient control was achieved. These 11 patients were treated successfully within five days using a highly purified insulin from the pig (Mixtard). Compared to the des-phe-mixed-insulin the dose could be reduced by 26% in average. Two patients developed an allergy against the des-phe-mixed-insulin; one locally, one generalized.

Topics: Adolescent; Adult; Aged; Diabetes Mellitus; Female; Humans; Insulin; Male; Middle Aged

Studies have been carried out in insulin-dependent diabetics of porcine Des-pheB1 insulin, which is an insulin analogue obtained by removal of the N-terminal aminoacid of the B chain. The therapeutic activity of Des-phe insulin (regular and semilinte preparations) was tested in a group of 24 insulin-dependent diabetics and compared with the unmodified parent compound. Both types of insulin, Des-phe and unmodified were chromatographically purified preparations. The mean daily blood glucose profile obtained with Des-phe insulin was slightly higher than that of unmodified preparations, while the mean blood glucose and the "M" index of Schlichtkrull were similar. The biological activity of regular Des-phe and its unmodified parent compound was evaluated in 6 further insulin-dependent diabetics, with the aid of an artificial endocrine pancreas. The insulin requirement to achieve an optimal metabolic control was 10% less with Des-phe insulin than with the unmodified preparation. The immunogenicity of Des-phe and unmodified insulins, tested by measuring plasma insulin antibody titres in diabetic patients either newly or already insulin treated, was comparable. However the binding capacity of 125I-Des-phe insulin to preexisting antibodies seemed to be less than that of unmodified 125I-insulin in patients previously treated with unmodified insulin. Finally Des-phe appeared able to correct promptly and completely the insulin-induced lipodystrophy of three insulin-dependent diabetics.

Topics: Adult; Aged; Animals; Blood Glucose; Clinical Trials as Topic; Diabetes Mellitus; Female; Humans; Insulin; Lipid Metabolism; Male; Middle Aged; Swine

Circulating insulin binding capacity was studied for 10 to 24 months in forty diabetic patients who were being treated with insulin for the first time. They received either neutral highly purified pork insulin, bovine or porcine desphe insulin containing formulations, semisynthetic human insulin, or "conventional" acid chromatographed bovine surfen insulin over the entire duration of the study. In only 6 of the 23 patients on pork insulin, porcine desphe insulin, or human insulin were minimal antibody concentrations (less than or equal to 2 IU/l) observed. The bovine desphe insulin containing beef insulin, was markedly more immunogenic: only 3 out of 12 patients did not produce any antibodies. All five patients treated with bovine surfen insulin reacted with a strong antibody formation, which was, on average, six times as high as that in the patients on bovine desphe insulin (approximately 90 vs 14 IU/l). According to these results, bovine desphe insulins should be considered more valuable in insulin therapy than formulations of unmodified beef or of mixed beef/pork insulins.

Topics: Binding Sites, Antibody; Diabetes Mellitus; Humans; Insulin; Insulin Antibodies; Insulin, Regular, Pork; Prospective Studies

At a geriatric department 61 insulin-dependent diabetics have been treated with des-phe-insulin (DPI) for periods of up to 6 years since 1976. The use of either pure DPI, amorphous DPI or DPI mixed with varying amounts of crystalline non-modified insulin of the same species allowed flexible longterm therapy, as well as management of metabolic emergencies. Comparison of the doses needed before and after change to and from other insulin preparations showed no difference in efficacy. No side effects of such severity as to necessitate interruption of therapy were observed.

Topics: Adult; Aged; Diabetes Mellitus; Diabetic Ketoacidosis; Drug Tolerance; Humans; Insulin; Long-Term Care; Middle Aged; Sulfonylurea Compounds

Des-phe-insulins are modified insulins in which phenylalanin is eliminated from the b-chain of the normal insulin. Preparations containing des-phe-insulin and cristalline insulin have a good stability and one can produce insulins with different profiles. 50 diabetics were treated with different des-phe-insulin containing preparations. The carbohydrate metabolism was well controlled during the application of the new preparations. There were no side effects nor skin allergies. Des-phe-insulin containing insulins present a new interesting aspect in the treatment of insulin dependent diabetes mellitus.

Topics: Adult; Aged; Delayed-Action Preparations; Diabetes Mellitus; Drug Combinations; Female; Humans; Insulin; Insulin, Long-Acting; Male; Middle Aged